The British Journal of Psychiatry (2010) 196: 52-58. doi: 10.1192/bjp.bp.108.058586
© 2010 The Royal College of Psychiatrists
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White matter microstructural abnormalities in euthymic bipolar disorder

Karine A. N. Macritchie, BSc(Hons), MB ChB, MD, MRCPsych and Adrian J. Lloyd, MB BS, MRCPsych, MD(Hons)

Psychobiology Research Group, Institute of Neuroscience, Newcastle University

Mark E. Bastin, DPhil

Medical and Radiological Sciences and SFC Brain Imaging Research Centre, University of Edinburgh and Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration

Kamini Vasudev, MD, DNB(Pharmacology), MRCPsych, Peter Gallagher, BSc(Hons), MPhil and Rachel Eyre, BSc, MRes

Psychobiology Research Group, Institute of Neuroscience, Newcastle University, UK

Ian Marshall, PhD, CEng, CSci, FIPEM

Medical and Radiological Sciences and SFC Brain Imaging Research Centre, University of Edinburgh and Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration

Joanna M. Wardlaw, BSc, MB ChB, FRCR, FRCP, FMedSci, MD

Division of Clinical Neurosciences and SFC Brain Imaging Research Centre, University of Edinburgh and Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration

I. Nicol Ferrier, BSc(Hons), MD(Hons), FRCP(Ed), FRCPsych, P. Brian Moore, MB BS, BSc, PhD, FRCPsych and Allan H. Young, MB ChB, MPhil, PhD, FRCPsych, FRCPS

Psychobiology Research Group, Institute of Neuroscience, Newcastle University, UK

Correspondence: Correspondence: Karine A.N. Macritchie, Institute of Mental Health, Department of Psychiatry, University of British Columbia, Suite 430 – Strangway Building, 5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada. Email: karine.macritchie{at}gmail.com

Declaration of interest

None.

Background

Abnormal diffusion parameters are reported in specific brain regions and white matter tracts in bipolar disorder.

Aims

To investigate whether these abnormalities are generalised, and thus evident in large regions of white matter.

Method

Diffusion parameters were measured at several regions in the corpus callosum and in deep/periventricular white matter in 28 currently euthymic patients with bipolar disorder and controls. White matter hyperintensity loads were assessed.

Results

Comparing the whole data-sets using the sign test, in the group with bipolar disorder, mean diffusivity was greater at all 15 sites (P<0.001) and fractional anisotropy was reduced at 13 (P<0.01). The effect of diagnosis was significant for callosal mean diffusivity and fractional anisotropy and for deep/periventricular mean diffusivity (MANCOVA). Comparing individual regions (Mann–Whitney U-test), prefrontal and periventricular mean diffusivity were significantly increased; callosal and occipital fractional anisotropy were significantly reduced. Former substance use and lithium were possible confounding factors. Periventricular white matter hyperintensities were associated with significantly increased periventricular mean diffusivity in individuals with bipolar disorder.

Conclusions

Generalised white matter microstructural abnormalities may exist in bipolar disorder, possibly exacerbated by past substance use and ameliorated by lithium.


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